Commentary on Use of Nape and Peri-Auricular Hair by Follicular Unit Extraction to Create Soft Hairlines and Temples: My Experience with 128 Patients

The document is a commentary on Dr. Umar's experience with 128 patients where he used nape and peri-auricular (NPA) hair for follicular unit extraction (FUE) to create natural-looking hairlines and temples. Dr. Umar's approach involved using softer, slightly miniaturized NPA hairs as vanguard hair for the anterior hairline, which resulted in high patient satisfaction. However, concerns about the permanence of NPA hair due to potential loss from progressive pattern alopecia were addressed by a subjective "shave test" to determine the long-term suitability of this donor area. About 25% of patients reported shedding of these hairs, prompting the incorporation of SDA hair into hairlines and temples to maintain a conventional look if NPA hair is lost. Dr. Umar also developed a specialized tool for FUE harvesting in the NPA region. The commentary suggests that while NPA hair is not commonly used, it can be a valuable option in selected cases, and the article is important for highlighting the refinements in hair transplantation using FUE.